Higher Levels Of Posttraumatic Symptoms Research Articles

Posttraumatic Stress and Perceived Interpersonal Provocation in Adolescents.

Objective: To examine the impact of posttraumatic stress on the choice of responses to and attribution of intentionality in peer provocation in adolescent boys and girls. Methods: A sample of 2678 adolescents from Northern Russia, aged 13-17 years (59.3% female; 95.7% ethnic Russian) completed self-reports on posttraumatic stress and rated hypothetical peer provocation scenarios that teenagers can encounter in their daily lives. Results: Adolescents with clinically significant levels of posttraumatic stress symptoms (n=184 (6.8%)) reported a different pattern of reactions to peer provocation as compared to all other adolescents. Boys and girls with high levels of posttraumatic symptoms reported that they would be less likely to discuss conflict situations and more likely to react with physical aggression. Compared to their male counterparts, girls with high levels of posttraumatic stress symptoms were more likely to endorse hostile intentions, avoid provocations, and were less likely to endorse verbally aggressive responses. In provocation scenarios that involved physical aggression, girls with high levels of posttraumatic stress symptoms were less likely to endorse verbal aggressive responses and more likely to endorse physically aggressive responses than girls without clinically significant levels of posttraumatic symptoms. Girls with high levels of posttraumatic stress symptoms were also more likely to avoid socially aggressive situations than non-traumatized girls, whereas boys had an opposite pattern. Conclusions: High levels of posttraumatic stress symptoms may play a significant role in the endorsement of aggressive reactions in conflicts with peers and patterns of reactions may be gender-specific. A history of posttraumatic stress should be carefully evaluated in children and adolescents seeking treatment for aggressive behavior.

The impact of COVID-19 pandemic on individuals at clinical high-risk for psychosis: Evidence from eye-tracking measures

Emerging evidence suggested that people with severe mental disorders were more vulnerable to the negative effects of the COVID-19 pandemic. However, few researches investigated the influence of global pandemics on people at clinical high risk (CHR) for psychosis. This study aimed to investigate the impact of the COVID-19 pandemic on clinical symptoms, psychological distress, and eye-tracking characteristics in CHR individuals and healthy participants. Forty-nine CHR individuals and 50 healthy controls (HC) were assessed by PTSD Checklist for DSM-5 (PCL-5), Perceived Stress Scale, 10-item version (PSS-10), and Coronavirus Impact Scale (CIS). Eye movement performances were measured by the tests of fixation stability, free-viewing, and anti-saccade. According to the mean score of CIS, participants were stratified into high-impact (n = 35) and low-impact (n = 64) subgroups. Compared with the HC group, CHR participants reported significantly higher levels of post-traumatic symptoms caused by the COVID-19 pandemic and showed abnormalities in most of the eye movement indexes. Among the altered indexes, the saccade amplitude of fixation stability test (far distractor), the scan path length of free-viewing test, and the accuracy of anti-saccade test were negatively affected by the severity of impact level in the CHR group. Moreover, the altered eye movement indexes were significantly associated with the total scores of CIS, PCL-5, and subscales of the Scale of Prodromal Syndromes (SOPS) among CHR individuals. Overall, our findings suggested the negative impact of the COVID-19 pandemic on the eye movement characteristics of CHR individuals. The present study provides valuable information on physiological distress related to the COVID-19 pandemic and sensitive neuropsychological biomarkers that interacted with social and environment stress in the CHR population.

The role of exposure to child abuse, social exclusion, and discrimination in predicting posttraumatic symptoms and resilience among young Arab women in Israel.

Child abuse has been demonstrated to have long-term negative effects on mental and social functioning. However, only few studies have focused on ethnic minority women. Our study examined the role of exposure to child abuse, social exclusion, and discrimination in predicting posttraumatic symptoms and resilience among young Arab women in Israel. Young Arab women (n = 482) aged 18-25 filled out questionnaires regarding background information, exposure to child abuse (Childhood Trauma Questionnaire-Short Form), social exclusion, perceived discrimination, posttraumatic stress symptoms (Screen for Posttraumatic Stress Symptoms), and resilience (Connor-Davidson Resilience Scale-10). Participants who experienced child abuse reported higher levels of social exclusion, perceived discrimination, and posttraumatic symptoms and lower levels of resilience, compared to participants who did not experience child abuse. Experiencing child abuse, social exclusion, and discrimination were associated with higher levels of posttraumatic symptoms. Social exclusion moderated the association between child abuse and resilience. Consistent with the concept of intersectional trauma, the findings show that both child abuse and social exclusion play a significant role in predicting posttraumatic symptoms and resilience among young Arab women. Accordingly, we need to embrace a context-informed perspective in research and practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Burnout Status of Italian Healthcare Workers during the First COVID-19 Pandemic Peak Period.

The pandemic of 2019 coronavirus disease (COVID-19) has burdened extraordinary psychological stress on the healthcare workforce. The present survey aimed to examine the personal resources and psychological symptoms associated with burnout in 933 healthcare workers in Italy during the COVID-19 outbreak period. Sociodemographic and occupational data, depression, anxiety, burnout, and post-traumatic symptoms, as well as psychological well-being, were cross-sectional assessed through an online questionnaire. A considerable part of the sample scored over the clinical levels of depression (57.9%), anxiety (65.2%), post-traumatic symptoms (55%), and burnout (25.61%). Working in the front-line (p < 0.05), being part of the medical staff (p < 0.05), experiencing lower levels of psychological well-being (p < 0.001), and higher levels of post-traumatic symptoms (p < 0.001) independently explained 38% of burnout variance. The healthcare industry, services, and professionals should be aware of the harmful effects of COVID-19 on healthcare workers and take adequate preventive measures.

Predictors of posttraumatic stress symptoms and perceived health after an acute coronary syndrome: the role of experiential avoidance, anxiety sensitivity, and depressive symptoms

Objectives: The identification of psychological markers of the posttraumatic stress reaction after a cardiac event is relevant in the management of cardiovascular risk factors. The aim of the study to test the contribution of experiential avoidance, anxiety sensitivity, and depressive symptoms to acute coronary syndrome posttraumatic stress symptoms and perceived health (both measured 6 months later), and to determine whether the associations between experiential avoidance, anxiety sensitivity, and depressive symptoms with perceived health were mediated by the posttraumatic stress symptoms.Design: 180 patients with acute coronary syndrome completed a survey over a 6-month period.Results: Anxiety sensitivity and depressive symptoms but not experiential avoidance contributed significantly to posttraumatic stress symptoms. Depressive symptoms and posttraumatic symptoms but neither anxiety sensitivity nor experiential avoidance had a significant association on perceived health. Acute coronary syndrome posttraumatic symptoms significantly mediated the association of depressive symptoms with perceived health. That is, increased depressive symptoms was significantly associated with higher levels of posttraumatic symptoms, which in turn predicted lower levels of perceived health.Conclusions: Understanding the psychological factors that are associated with post-acute coronary syndrome posttraumatic stress symptoms may help to identify patients at risk in order to refer them to the appropriate psychological care service.

Impact of Stressful Events on Motivations, Self-Efficacy, and Development of Post-Traumatic Symptoms among Youth Volunteers in Emergency Medical Services.

During the last decades, Israeli emergency medical services (EMS) personnel has been exposed to different potentially traumatic events, including mass terror attacks. The aims of the present study were to identify how potentially traumatic events affect young volunteers in their motivation to volunteer and their perceived self-efficacy while being at risk of developing post-traumatic symptoms. The final sample included 236 Magen David Adom (MDA, the "Israeli Red Cross") youth volunteers. The study evaluated their motivational factors for volunteering, perceived self-efficacy, participation in potentially traumatic events, and post-traumatic symptoms. Over two-thirds of the volunteers participated in a traumatic event on duty. Volunteers who were involved in potentially stressful events scored higher levels of post-traumatic symptoms, though still very low and subclinical. Nonetheless, participating in stressful events contributed to an increased sense of self-efficacy. No difference in post-traumatic symptom levels was observed between volunteers who partook in mass casualty incidents and those who did not. The results demonstrate that MDA youth volunteers may mostly benefit from participating in situations requiring the administration of emergency medicine, even stressful ones. They may help to find ways to empower the volunteers and increase their resilience.

Children's emotional and behavioral problems in the shadow of terrorism: The case of Israel

This research investigates the well-being of children subjected to prolonged exposure to missile attacks. A study of post-traumatic symptoms, emotional stress, and behavioral problems among 152 children from southern Israel, an area prone to missile attacks, was conducted. Post-traumatic symptoms were assessed by a self-reported version of the Post-traumatic Stress Disorder Reaction Index for Children (CPTS-RI). Emotional and behavioral problems were assessed by the Child Behavioral Checklist (CBCL), which was completed by the children's mothers. The mothers were asked to answer the CBCL regarding their children's behavior both in the present and prior to the missile attacks. CBCL results were then compared with those of comparable children (n = 125) living in central Israel who were not exposed to missile attacks and whose mothers were asked to answer a similar questionnaire. The results indicated that prolonged exposure to security threats did not result in high levels of posttraumatic symptoms. However, according to the mothers the emotional and behavioral states of the children deteriorated. This was found also when their current emotional and behavioral state was compared to similar children in central Israel. The complex effect of prolonged exposure to security threats is discussed.

The Contribution of Cognitive Strategies to the Resilience of Women Survivors of Childhood Sexual Abuse and Non-Abused Women.

This study examines the contribution of four strategies-self-forgiveness, realistic control, unrealistic control, and hope-to the resilience of 100 women survivors of childhood sexual abuse (CSA), as compared with 84 non-sexually abused women. The findings show that CSA survivors exhibited lower resilience, lower self-forgiveness, lower hope, and higher levels of posttraumatic symptoms (PTS). They also indicate that resilience was explained by the participants' financial status, PTS severity, and two cognitive strategies-self-forgiveness and hope. Finally, PTS and hope mediated the relation between CSA and resilience.

Posttraumatic Stress among Victimized Latino Women: Evaluating the Role of Cultural Factors.

Research examining victimization and posttraumatic symptomatology among Latinos is lacking in the extant literature. This analysis used the victimized subsample (N = 752) of the Sexual Assault Among Latinas Study. The aim was to evaluate victimization prevalence and test the following hypotheses: (a) that victimization would be associated with higher levels of posttraumatic symptoms, (b) that cultural factors that move away from traditional Latino culture would be associated with higher levels of posttraumatic symptomatology, and (c) that cultural factors associated with traditional Latino culture would be related to lower posttraumatic symptomatology. Average age of the sample was 44.57 years, with three fourths having a high school education or higher, and two thirds having a household income below $30,000. Of exposure types, adulthood threats were most likely to result in Criterion A traumatic events (23.4%). Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) based PTSD Checklist, between 8.8% and 45.5% of individuals met presumed PTSD diagnosis based on various PCL cut scores or algorithm criteria. Regression analyses indicated that the combined different types of adult and childhood victimizations, masculine gender role, and negative religious coping were associated with increased symptoms (βs ranging from .16 to .27). The results suggested a role of culture in posttraumatic symptoms for Latinas.

Loneliness Trajectories: The Role of Posttraumatic Symptoms and Social Support

This study prospectively examines the longitudinal course of loneliness, social support, and posttraumatic symptoms (PTS) among Israeli war veterans. Two groups of veterans with and without antecedent combat stress reaction (CSR) were assessed at three points of time during a 20-year period. Veterans with CSR reported higher levels of loneliness compared with veterans without CSR. Loneliness remained stable among veterans with CSR but decreased among veterans without CSR. Baseline level of social support predicted the trajectory of change in loneliness. Finally, higher levels of PTS and lower levels of social support were associated with more loneliness among veterans with CSR.

Do adolescents know when they need help in the aftermath of war?

This study examined Israeli Arab and Jewish students' reports on needing help, a year after the Second Lebanon War and whether students' requests for support were associated with posttraumatic distress. The representative sample included 1,800 Jewish and 2,351 Arab students, grades 7-11. The questionnaires included items regarding (a) exposure to wartime events and other negative life events, (b) measures of posttraumatic stress disorder, and (c) needing help. The results showed that about 30% of the students reported needing help from any source (e.g., parents, peers) in the aftermath of the war. Arab students were more likely to report needing help than Jewish students. The students who reported needing help experienced higher levels of posttraumatic symptoms.

Marital Adjustment, Parental Functioning, and Emotional Sharing in War Veterans

The current study aimed to examine the implications of posttraumatic stress disorder symptoms and emotional sharing in marital adjustment and parental functioning among Israeli veterans of the 1982 Lebanon War. The sample consisted of combat stress reaction (CSR) veterans ( n = 264) and non-CSR veterans ( n = 209). Results show that traumatized veterans reported lower levels of marital adjustment and more problems in parental functioning. Furthermore, higher levels of posttraumatic symptoms, especially avoidance symptoms, were related to a decrease in marital adjustment and parental functioning. Most important, emotional sharing was found to moderate the relation between posttraumatic stress disorder severity and parental functioning. Possible explanations, limitations of the current study, and recommendations for future research are presented.

Dissociation and Posttraumatic Symptoms in Maltreated Preschool Children.

This study examines dissociation and posttraumatic symptomatology in a sample of maltreated preschool-age children in foster care. Analyses compared Child Behavior Checklist subscale scores for the foster care sample and a community sample, and also examined differences between maltreatment subtypes. Exposure to any type of maltreatment was associated with greater dissociation and posttraumatic symptomatology in this sample. Preschool-age children with documented sexual abuse displayed high levels of posttraumatic symptoms, whereas children with documented physical abuse tended to use dissociation as a primary coping mechanism. The finding that physically abused children had high levels of dissociation confirms previous research with preschoolers.

Palestinian Youth of the Intifada: PTSD and Future Orientation

To assess the nature of chronic exposure to terror and its psychological and cognitive toll on Palestinian youths, as is reflected in posttraumatic symptoms, future orientation, and attitudes toward peace. In the summer of 2001, 245 Palestinian and 300 Israeli-Palestinian adolescents in the sixth to ninth grades were assessed with self-report questionnaires that measured level of exposure to terror, posttraumatic stress disorder, anxiety, depression, anger, dissociation, future orientation, and attitudes toward peace. Palestinians experienced significantly more traumatic events than Israeli Palestinians; the groups did not differ, however, in their subjective perception of the threat. Palestinians also reported higher levels of posttraumatic symptoms, more pessimistic future orientation, and less favorable attitudes toward peace negotiations than the Israeli Palestinians. The groups did not differ in reported psychological symptoms related to chronic exposure to stress. In both groups, subjective perceptions of the threat were implicated in the pathogenic sequelae of exposure to terror-induced trauma. Chronic or repeated exposure to terror may be related to complex posttraumatic symptoms beyond those specified in DSM-IV or ICD-10, including negative personal and national future orientation. The role of subjective appraisal deserves professional attention.

Psychiatric Symptoms and Cognitive Appraisal following the Near Sinking of a Research Submarine

This study assessed the stress reactions of a submarine crew forced to abandon their vessel in high seas after flooding and fire damaged their ship. The remaining crew members (n = 22) were surveyed 7 months after the incident regarding exposures, initial emotional responses, peritraumatic dissociation, subsequent life events, current safety appraisal, and current symptoms of posttraumatic stress disorder (PTSD) and depression. At 7 months, 9.1% met criteria for PTSD and none met criteria for depression. Higher levels of depressive symptoms were associated with previous traumatic exposures, subsequent life events, and higher levels of PTSD symptoms; higher levels of PTSD symptoms were associated with greater peritraumatic dissociation and initial emotional response. Acute exposures of highly trained professionals to potentially fatal events may not result in high levels of posttraumatic symptoms. Previous and subsequent life events may play a more significant role in the level of postdisaster symptoms.

Holocaust survivors coping with open heart surgery decades later: posttraumatic symptoms and quality of life

Objective History of prolonged traumatization has been associated with reduced quality of life (QoL) and difficulties in coping with major life-threatening conditions. We assessed the association between the impact of Holocaust experience (posttraumatic symptoms) and QoL of patients before and after an open heart surgery. Method Sixty-three Holocaust survivors were interviewed before open heart surgery (at admission), 52 at follow-up at 1 week, and 58 at follow-up at 6 months. The interview included background data, Impact of Event Scale (IES), Mastery scale, and QoL measured by the Nottingham Health Profile. Medical data were retrieved from the patients' charts. Results The total IES score indicate a high level of posttraumatic symptoms at all the time points (close to a mean of 18), but there was a clear trend of changes in the avoidance subscale: At admission, the patients manifested lower avoidance compared with the levels after the surgery and at the follow-up. No significant differences in IES were found by Holocaust experiences. Significant improvements in most components of QoL were found at the follow-up. In multivariate analyses at each time point, the findings show that those with higher levels of posttraumatic symptoms are more at risk for problems in pain and mobility domains of QoL at admission, for emotional reaction after the surgery, and at the follow-up, these associations are only at trend level, while lower sense of mastery became significant. Conclusions The improvement in QoL despite persistence of the impact of the Holocaust may indicate that past severe prolonged traumatization does not necessarily reduce the survivors' ability to cope with and regain physical and psychosocial functioning after a severe life-threatening medical condition. This may be further generalized to other significant crisis situations in life, such as prolonged periods of stress, suffered by many populations throughout the world.

From child victim to adult victim: a model for predicting sexual revictimization.

Women with histories of child sexual abuse (N = 221) participated in a study designed to test a model for predicting adult/adolescent sexual revictimization and post-assault functioning. Participants completed anonymous questionnaires regarding their sexual victimization history, post-sexual assault symptoms and attributions, and consensual sexual behavior. Repeated victimization was defined as having experienced child sexual abuse and a separate incident of adolescent/adult victimization. Repeated victimization was associated with having experienced child sexual abuse involving physical contact, including intercourse and/or penetration. Women with repeated victimization engaged in more self-blame, reported higher levels of post-traumatic symptoms, and reported more high-risk sexual behavior. A path model was developed that indicated that the relationship between revictimization and child sexual abuse was mediated by self-blame, post-traumatic symptoms, and consensual sexual activity. The results suggest the need for further research on revictimization as well as suggesting areas for intervention to prevent sexual revictimization.